Background and purposeThe purpose of this study was to add, to the objective evaluation, an instrumental assessment of the skin damage induced by radiation therapy.Materials and methodsA group of 100 patients affected by breast cancer was recruited in the study over one year. Patients were divided into five groups of 20 patients. For each group it was prescribed a different topical treatment. The following products were used: Betaglucan, sodium hyaluronate (Neoviderm®), Vitis vinifera A. s-I-M.t-O.dij (Ixoderm®), Alga Atlantica plus Ethylbisiminomethylguaicolo and Manganese Cloruro (Radioskin1®) and Metal Esculetina plus Ginko Biloba and Aloe vera (Radioskin 2®); Natural triglycerides-fitosterols (Xderit®); Selectiose plus thermal water of Avene (Trixera+®). All hydrating creams were applied twice a day starting 15 days before and one month after treatment with radiations. Before and during treatment patients underwent weekly skin assessments and corneometry to evaluate the symptoms related to skin toxicity and state of hydration. Evaluation of acute cutaneous toxicity was defined according to the RTOG scale.ResultsAll patients completed radiotherapy; 72% of patients presented a G1 cutaneous toxicity, 18% developed a G2 cutaneous toxicity, 10% developed a G3 toxicity, no one presented G4 toxicity. The corneometry study confirmed the protective role of effective creams used in radiation therapy of breast cancer and showed its usefulness to identify radiation-induced dermatitis in a very early stage.ConclusionsThe preventive use of topic products reduces the incidence of skin side effects in patients treated with radiotherapy for breast cancer. An instrumental evaluation of skin hydration can help the radiation oncologist to use strategies that prevent the onset of toxicity of high degree. All moisturizing creams used in this study were equally valid in the treatment of skin damage induced by radiotherapy.

Dermatofibroma (DF) is a common benign fibrohistiocytic lesion which presents with a wide variety of clinicopathological features. Generally, the clinical diagnosis is easy, but differentiating it from other cutaneous tumors could be difficult in atypical cases and rare variants. We may find at least four different histopathological variants of DF; more than one of which may be present in a single tumor. Hemosiderotic DF is a variant composed of numerous small vessels, extravasated erythrocytes, and intra- and extracellular hemosiderotic deposits. The differential diagnosis may comprise melanoma as well as other melanocytic and nonmelanocytic tumors. We report the case of a 38-year-old man who presented with a hemosiderotic DF on the abdomen.

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We describe a 31-year-old woman with an asymptomatic solitary red plaque on the back which measured 2 × 1 cm. The patient reported that it had been growing for a few months. Upon dermoscopic examination, multiple well-demarcated red globules were seen. At the periphery a fine pigment network was present. The lesion was excised and examined histopathologically. The specimen showed proliferation of irregular branching venules with inconspicuous lumina. The tumor cells lacked cellular atypia. Microvenular hemangioma is a rare, slowly growing, benign vascular tumor. It usually presents on the trunk or the extremities of young to middle-aged adults. Microvenular hemangioma is a benign vascular tumor with distinct dermoscopic and histopathological features which enable it to be distinguished from other vascular neoplasms.

Background Although long-term management of psoriasis is paramount, this approach is challenging in clinical practice. In the recent PSO-LONG trial, a fixed-dose combination of betamethasone dipropionate (BD) and calcipotriol (Cal) foam applied twice a week on nonconsecutive days for 52 weeks (proactive treatment) reduced the risk of relapse. However, the role of Cal/BD foam in the long-term management of psoriasis needs further clarifications. The ProActive Management (PAM) program, a nationwide Italian project, aims at reaching a consensus on the role of proactive management of psoriasis.Methods A steering committee generated some statements through the nominal group technique (NGT). The statements were voted by an expert panel in an adapted Delphi voting process.Results Eighteen statements were proposed, and the majority of them (14/18) reached a consensus during the Delphi voting. The need to provide long-term proactive topical treatment to reduce the risk of relapse for the treatment of challenging diseases sites or in patients where phototherapy or systemic therapies are contraindicated/ineffective was widely recognized. A consensus was reached about the possibility to associate the proactive treatment with systemic and biological therapies, without the need for dose intensification, thus favoring a prolonged remission. Moreover, the proactive treatment was recognized as more effective than weekend therapy in increasing time free from relapses.Approaches to improve adherence, on the other hand, need further investigation. ConclusionsThe inclusion in guidelines of a proactive strategy among the effective treatment options will be a fundamental step in the evolution of a mild-moderate psoriasis therapeutic approach.